CC-000694-2017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: CC-000694-2017
Tax Map No: 309.13-1-34
Permission is hereby granted to: Fastrac Markets,LLC,Fastrac Cafe
For property located at: 220 CORINTH RD
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
TVDe of Construction
Owner Name: Fastrac Markets,LLC Factory-Industrial-New $724,999.00
Owner Address: 6500 New Venture Gear DR Total Value $724,999.00
East Syracuse,NY 13057
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Petrol Canopy 6477 s.f.
Fastrac Market
$647.70 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,November 13,2018
(If a longer period is required,an application for an exten 'on must be made to the code Enforcement Officer
of the Town of QueensbIM&IIEfore the a atio date.
Dated at the Town o Queens M ember 13,2017
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
P% � 1
Office Use Only
Permit#: C� �r1 " 2g)
PRINCIPLE STRUCTURE PERMIT
APPLICATION Permit Fee:
r,,ti,n c�u�rbu, 'Rec Fee:$ N,f�
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 #1qvv.gueensburv.net Invoice#:
Project Location: 220 Corinth Road
Tax Map ID N: 309.13-1-35 Subdivision Name:
'TOWN BD.RESOLUTION 86-2013: $850 recreation fee for new dwelling units: single family,duplexes/two-family,
multiple family, apartments, condominiums,townhouses, and/or manufactured &modular homes, but not mobile
homes. This Is In addition to the permit fee(s).
CONTACT INFORMATION:
• Applicant:
Name(s): Fastrac Markets LLC
Mailing Address, C/S/Z: 6500 New Venture Gear Drive. East Svracuse. NY 13057
Cell Phone: ( ) Land Line: { 315 ) 552-6800
Email: bhuphesOfastracmarkets.com
• Primary Owner(s):
Name(s): Same as above
Mailing Address, C/S/Z:
Cell Phone: { ) Land Line: { )
Email:
• Contractor(s):
Business Name: Same as above
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: { {
Email:
• Arch itect(sV Engineer(s)
Business Name: Nelson Associates Architectural Enaineerina
Contact Name(s): Ronald Stafford
Mailing Address, C/S/Z: 1 North Park Row. Clinton. NY 13323
Cell Phone: ( ) Land Line: { 315 ) 853-5704
Email; rstaff9rdCa nelsonae.com
Contact Person for Building &Code Compliance: Same as above
Cell Phone: { ) Land Line: { )
Email:
Town of Queensbury Building&Code Enforcement Principle Structure Application Revised February 2017
PROJECT INFORMATION:
TYPE: X Commercial F:•:::ide��t��il
WORK CLASS:
_Single-Family _ Two-Family Multi-Family(#of )
Townhouse Business Office X Retail Hotel/Motel
_IndustriailWarehouse --Garage(#fofcars—) Other(describe )
STRUCTURE SQUARE FOOTAGE: GARAGE SQUARE FOOTAGE:
1ST floor: I OD 11T floor:
2nd floor: 2nd floor:
Y5\
31d floor: �2�p' Total square feet:
4`h floor
Total square feet:
ADDITIONAL PROJECT INFORMATION:,
1. Estimated Cost of Construction: $ 724,999.00
2. Proposed use of the building: Gasoline Station /Convenience Store
3. If Commercial or industrial, indicate the name of the business: >'astrac_Cafe
4. Source of Heat(circle one): Gas Oil Propane Solar Other:
(Fireplaces need a separate Fie Burning Appliances&chimney Application, one per appliance)
5. Are there any structures not shown on the plot plan? YES NO Explain:
5. Are there any easements on the property? YES NO
7. SITE INFORMATION:
a.What is the dimensions or acreage o the parcel? 2.15 acres
b.Is this a corner lot? YES NO
c.Will the grade be changed as a result of the construction? YES NO
d.What is the water source? PUBLI PRIVATE WELL
e. Is the parcel on SEWER or a PRIVATE SEPTIC system? Sewer
i _...... ._ •uf•S.^ad C^.. .. .:.n: Pnr�,pte_ ..F�:r _. iev���Fc�r .
DECLARATION:
1. 1 acknowledge that no construction small commence prior to issuance of a valid b u i I ding permit and
work will be completed within a 12 month period.
2. Ifthework is not completed by the 1 year expiration date the permit may be renewed, subject to
fees and department approval.
3. 1 certify that the application, plans and supporting materials are a true and 0omplete statement and/or
description of the work proposed, that all work will be performed in accordance with the NYS Building
Codes,local building laws and ordinances, and in conformance with local zoning regulations.
4. 1 acknowledge that prior to occupying the facilities proposed 1, or my agents, will obtain a certificate
of occupancy.
5. 1 also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all
newly constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME:
SIGNATURE: . DATE: r1 2 I
Town of Queensbury Building&code Enforcement Principle Structure Application ReYised February 2017